WEB WOC Ostomy Care, Complete Verified Solution 2023
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Course
WEB WOC Ostomy Care,
Institution
WEB WOC Ostomy Care,
WEB WOC Ostomy Care, Complete Verified Solution 2023
jejunostomy location
LUQ
*frequently not marked by the WOC nurse
jejunostomy disease and procedure
ischemic bowel, crohn's, trauma, necrotizing enterocolitis
diversion of small bowel at jejunum, with or without colectomy, with or withou...
WEB WOC Ostomy Care, Complete
Verified Solution 2023
jejunostomy location
LUQ
*frequently not marked by the WOC nurse
jejunostomy disease and procedure
ischemic bowel, crohn's, trauma, necrotizing enterocolitis
diversion of small bowel at jejunum, with or without colectomy, with or without small
bowel resection, loop or end stoma
jejunostomy function and management
*function begins in 24-48 hours
*initially gas, then watery clear/green output (fluid and digestive enzymes)
*output up to 2400ml/day
*empty pouch when 1/3 to 1/2 full
jejunostomy complications
*monitor for electrolyte imbalances and dehydration
*size pouch correctly to prevent leakage
*may need to change pouch every 2-3 days
ileostomy location
RUQ
ileostomy disease and procedure
crohn's, ulcerative colitis, familial adenomatous polyposis, trauma, necrotizing
enterocolitis, cancer, ischemic bowel
total proctocolectomy with end ileostomy, total proctocolectomy with continent
ileostomy, temporary ileostomy, temporary loop ileostomy for ileal pouch-anal
anastomosis
ileostomy function and management
*function begins in 24-48 hours
*initially gas, then liquid output for several days, then becomes mushy
*output of 500-600 ml/day (higher output the higher up in the ileum stoma is)
*empty pouch when 1/3 to 1/2 full
*protect peristomal skin
*watch for fluid and electrolyte imbalance
ileostomy complications
*high risk for bowel obstruction-instruct pt to chew food thoroughly and drink lots of
water
*potential risk for vitamin B12 deficiency
transverse colostomy location
RUQ or LUQ
transverse colostomy disease and procedure
diversion of large bowel at the transverse colon, with or without colectomy, usually
temporary loop stoma
transverse colostomy function and management
*function begins within 48 hours
*initially gas, then mushy or semi-formed
*may have urge to poop with mucous from rectum
*no effect on nutritional absorption
transverse colostomy complications
*waistline location can be difficult to manage
descending colostomy location
LLQ
descending colostomy disease and procedure
colorectal cancer, trauma, bowel perforation, ischemic bowel
permanent end colostomy with rectum and anus removed, temporary or permanent end
colostomy with Hartmann's pouch (sewing shut top of rectum with ability to reconnect to
GI tract later)
descending colostomy function and management
*function may not begin for up to 5 days post-op
*initially gas, then liquid, then semi-formed to formed
*odor and gas of concern due to higher amounts of bacteria
*may need colostomy irrigation routinely
descending colostomy complications
*monitor, prevent, and manage constipation
*may cause erectile dysfunction
continent ileostomy (kock pouch)
total proctocolectomy performed and abdominal ileal pouch is made. The continence
mechanism is a nipple valve constructed in the pouch by intussusception.
ileal pouch anal anastomosis (IPAA)
usually done in 1, 2, or 3 stages
the colon and most of the rectum are removed, but the anus remains intact, a pouch is
constructed from the ileum and anastomosed to the distal rectum, a temporary loop
ileostomy is created to divert stool while the anastomosis heals, the ileostomy is taken
down once the suture lines heal and normal bowel function is restored
ileal/colon conduit location
ileal: RLQ
colon: LLQ
ileal/colon conduit disease and procedure
bladder cancer, neurogenic bladder, refractory interstitial cystitis, pre-existing small
bowel disease indicates use of colon conduit instead
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